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Successful use of Nutritional Guidelines to Prevent Type II Diabetes

Successful use of Nutritional Guidelines to Prevent Type II Diabetes. James J. Kenney PhD, RD. Pathophysiology of Insulin Resistance and It ’ s Metabolic Sequelae. Modern Low Satiety Diet & Inactivity. Excessive Energy Intake. Increase Body fat Stores. Insulin Resistance (Hyperinsulinemia.

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Successful use of Nutritional Guidelines to Prevent Type II Diabetes

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  1. Successful use of Nutritional Guidelines to Prevent Type II Diabetes James J. Kenney PhD, RD

  2. Pathophysiology of Insulin Resistance and It’s Metabolic Sequelae Modern Low Satiety Diet & Inactivity Excessive Energy Intake Increase Body fat Stores Insulin Resistance (Hyperinsulinemia Dyslipemeia Salt Retention & NO Loss of Beta Cells Small Dense LDLs + TG + HDL BP BS & IGT Atherosclerosis HTN Type 2 Diabetes CVD Kidney failure Other DM Complications

  3. Pathophysiology of Insulin Resistance and It’s Metabolic Sequelae Modern Low Satiety Diet & Inactivity Excessive Energy Intake Increase Body fat Stores Insulin Resistance (Hyperinsulinemia Dyslipemeia Salt Retention & NO Loss of Beta Cells Small Dense LDLs + TG + HDL BP BS & IGT Atherosclerosis HTN Type 2 Diabetes CVD Kidney failure Other DM Complications

  4. NCEP Guidelines for Clinical Classification of those with the Metabolic Syndrome

  5. NCEP Guidelines for Clinical Classification of those with the Metabolic Syndrome Risk Factor Defining Level 1.Abdominal Obesity Waist circumference Men >40 in. Women >35 in

  6. NCEP Guidelines for Clinical Classification of those with the Metabolic Syndrome Risk Factor Defining Level 1.Abdominal Obesity Waist circumference Men >40 in. Women >35 in 2.Triglycerides >150mg/dl

  7. NCEP Guidelines for Clinical Classification of those with the Metabolic Syndrome Risk Factor Defining Level 1.Abdominal Obesity Waist circumference Men >40 in. Women >35 in 2.Triglycerides >150mg/dl 3.High-density lipoprotein cholesterol Men <40mg/dl Women <50mg/dl

  8. NCEP Guidelines for Clinical Classification of those with the Metabolic Syndrome Risk Factor Defining Level 1.Abdominal Obesity Waist circumference Men >40 in. Women >35 in 2.Triglycerides >150mg/dl 3.High-density lipoprotein cholesterol Men <40mg/dl Women <50mg/dl 4. Blood pressure >130/>85mm Hg

  9. NCEP Guidelines for Clinical Classification of those with the Metabolic Syndrome Risk Factor Defining Level 1.Abdominal Obesity Waist circumference Men >40 in. Women >35 in 2.Triglycerides >150mg/dl 3.High-density lipoprotein cholesterol Men <40mg/dl Women <50mg/dl 4. Blood pressure >130/>85mm Hg 5. Fasting glucose >110mg/dl

  10. Percent of Adults Classified as Having the Metabolic Syndrome Using New NCEP Criteria Ford ES, et. al. JAMA 2001;287:356

  11. Fasting Insulin Levels and Body Weight Bagdadeet al. J Clin Invest. 1967;46:1549

  12. Relative risk of developing Type 2 DM in middle-aged US women Colditz GA, et al. Ann Intern Med 1995;122:481

  13. Incidence of new diagnoses of diabetes in participants of the Diabetes Prevention Program 40 _ 30 _ 20 _ 10 _ 0 Placebo (n = 1082) Metformin (n = 1073, p<.001 vs. placebo Lifestyle (n=1079, P<.001 vs. metformin, P< .001 vs. placebo Risk Reduction 31% by Metformin 58% by lifestyle Cumulative Incidence (%) Adapted d from Knowler WC, et al. N Engl J Med 2002;346(6):394-403 0 1 2 3 4 Years from Randomization

  14. Effect of Dietary Fat on Ad Libitum Energy Intake Lissner L. et al. Am J Clin Nutr 1987;46:886

  15. Effects of High- and Low-Energy Density Diets on Ad Libitum Calorie Intake 4200 3800 3350 2850 2400 1900 1400,, Energy Intake (Kcalories) Stubbs RJ, et al. Int J Obesity 1998;22:885-92

  16. Impact of High-Fat, Moderate-Fat and Very-Low-Fat Diets Fed Isocalorically or Ad Libitum on Fasting Triglyceride Levels Parks EJ. Am J Clin Nutr 2000;71:424

  17. The Average % Change in CVD-Risk Factors After One Year on 4 Different Weight Loss Dietary Programs Fleming RM. Prev Cardiol 2002;5:110

  18. The Average % Change in CVD-Risk Factors After One Year on 4 Different Weight Loss Dietary Programs Diet Weight TC LDL HDL TG Hcy Lp(a) Fibrinogen MF = Moderate Fat; LF-1 =10% Fat, LF-2 =15% Fat, and HF = High-Fat Atkins-style diet Fleming RM. Prev Cardiol 2002;5:110

  19. The Average % Change in CVD-Risk Factors After One Year on 4 Different Weight Loss Dietary Programs Diet Weight TC LDL HDL TG Hcy Lp(a) Fibrinogen MF -2.6 -5.0 -6.1 -1.5 +1.0 +9.7 +4.7 -0.6 MF = Moderate Fat; Fleming RM. Prev Cardiol 2002;5:110

  20. The Average % Change in CVD-Risk Factors After One Year on 4 Different Weight Loss Dietary Programs Diet Weight TC LDL HDL TG HcyLp(a) Fibrinogen MF -2.6 -5.0 -6.1 -1.5 +1.0 +9.7 +4.7 -0.6 LF-1 -18.4 -39.1 -52.0 +9.0 -37.3 -13.6 -7.4 -11.0 MF = Moderate Fat; LF-1 =10% Fat, Fleming RM. Prev Cardiol 2002;5:110

  21. The Average % Change in CVD-Risk Factors After One Year on 4 Different Weight Loss Dietary Programs Diet Weight TC LDL HDL TG HcyLp(a) Fibrinogen MF -2.6 -5.0 -6.1 -1.5 +1.0 +9.7 +4.7 -0.6 LF-1 -18.4 -39.1 -52.0 +9.0 -37.3 -13.6 -7.4 -11.0 LF-2 -12.6 -30.4 -38.8 +3.6 -36.9 -14.6 -10.8 -6.3 MF = Moderate Fat; LF-1 =10% Fat, LF-2 =15% Fat, Fleming RM. Prev Cardiol 2002;5:110

  22. The Average % Change in CVD-Risk Factors After One Year on 4 Different Weight Loss Dietary Programs Diet Weight TC LDL HDL TG HcyLp(a) Fibrinogen MF -2.6 -5.0 -6.1 -1.5 +1.0 +9.7 +4.7 -0.6 LF-1 -18.4 -39.1 -52.0 +9.0 -37.3 -13.6 -7.4 -11.0 LF-2 -12.6 -30.4 -38.8 +3.6 -36.9 -14.6 -10.8 -6.3 HF -13.7 + 4.3 +6.0 -5.8 +9.8 +12.4 +31.0 +11.9 MF = Moderate Fat; LF-1 =10% Fat, LF-2 =15% Fat, and HF = High-Fat Atkins-style diet Fleming RM. Prev Cardiol 2002;5:110

  23. Bread is considered the standard

  24. Glycemic Index of Selected Foods Croissant 67 Bananas 54 Cake, pound 54 Grapes 46 Doughnuts 76 Apples 38 Cookies 55 Oranges 44 Crackers 71 Watermelon 72 Sweet corn 55 Peach 42 Mars Candy Bar 64 Pear 37 Peanuts 15 Plum 39 Yogurt 36 Mango 56 Waffles 76 Kiwi 53 Ice Cream, low-fat 51 Grapefruit 25

  25. Glycemic Index of Selected Foods Jellybeans 80 Cherries 22 Popcorn 55 Raisins 64 M&Ms, peanut 32 Pineapple 66 White Bread 71 Cantaloupe 65 French fries 54 Apricots 57 Pasta, white 41 Dates 103 Rice, brown 55 Lentils 29 Rice, white 58 Soybeans 18 Bread, wh wheat 69 Kidney Beans 29

  26. Satiety Index of Common Foods

  27. Effect of S.A.D. and DASH Diets on SBP at different Sodium Intake levels.

  28. 10 Best Reasons to Avoid the Atkins Diet 1. Heart Disease Risk Increases 2. Cancer Risk Increases 3. Poor Long-Term Weight Control 4. Reduced Athletic Performance 5. Rising Blood Pressure Likely 6. Kidney Stones 7. Gout 8. Osteoporosis 9. Fainting 10. Keto-breath By Dr. James J. Kenney, PhD, RD, FACN.

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